The present invention relates to female urinary stress incontinence and provides a method and means for treatment.
The prior art reveals a variety of methods and devices for treating female urinary incontinence including surgical procedures for implanting corrective devices.
Lemay U.S. Pat. No. 5,013,192 discloses a surgical technique using local anesthesia for burying a pair of implants to the left and right of a median line at the superior border of the symphsis pubis, threading suture from the vagina through each implant and back through the vagina to provide two ends of each suture protruding from the vagina, and tying the first and second ends of the left and right sutures, respectively, to support and constrict the urethra. Lemay discloses a reinforcing element such as a small strip of biologically acceptable cloth (e.g., Dacron) under the tied ends of the sutures. Lemay also discloses the use of a supporting saddle for holding the neck of the urethra in case incontinence reoccurs after a first procedure. A problem with Lemay is that the lower implant platform may, in time, damage the urethra causing other problems.
Robertson U.S. Pat. No. 5,019,032 improves the Gittes and Loughlin pubovaginal suspension technique for treating incontinence by means of installing sutures between the rectus fascia and vagina. Robertson is primarily concerned with proper placement of the sutures and particularly avoiding the bladder and urethra.
Petros U.S. Pat. No. 5,112,344 discloses a method for treating female incontinence in which a filament is looped between the wall of the vagina and the rectus abdominis sheath in the anterior wall of the abdomen passing to each side of the urethra, and the filament is tightened to bring the vaginal wall and urethra into correct spatial relationship with respect to the pubis so that scar tissue develops between the vaginal wall and the anterior wall of the abdomen. The filament is removed after scar tissue develops. The scar tissue provides a ligament-like interconnection between the vaginal wall and the muscle tissue at the anterior surface of the abdomen.
Annis et al U.S. Pat. No. 4,857,041 discloses a prosthetic device for female incontenence in the form of a cuff around the urethra positioned by sutures attached to the rectus sheath.
Trick et al U.S. Pat. No. 5,114,398 discloses a valve structure placed in the bladder and urethra for treating female incontinence.
Haber U.S. Pat. No. 5,064,434 discloses an implant inserted hypodermically in the vicinity of the urethra to increase local tissue volume in order to control incontinence.
Fernandez et al discloses an artificial sphincter in the form of a magnetic implant for female incontinence.
Hodgson U.S. Pat. No. 4,556,050 discloses an artificial sphincter implant for incontinence using a shape memory member fabricated of NiTinol. The shape memory member has a memory configuration to which the member recovers when heated to recovery temperatures.
In addition to the above patented solutions, there are several common needle suspension procedures for treating stress incontinence including modified Pereyra in which suture interconnects subcutaneous tissue above the rectus fascia to tissue on both sides of the urethra; Raz in which suture interconnects subcutaneous tissue above the rectus fascia to the vaginal wall on both sides of the urethra; and Stamey in which suture interconnects subcutaneous tissue above the rectus fascia to Dacron sleeves located in tissue on both sides of the urethra.
The foregoing patent disclosures and common surgical procedures propose a variety of solutions to the matter of female urinary stress incontinence, nonetheless, none of these disclosures reveal a solution of general application and the challenge is to find simpler ways to correct it.